H. Shao, J. Chung, K. Lee, L. Balaj, C. Min, B. S. Carter, F. H. Hochberg, X. O. Breakefield, H. Lee, and R. Weissleder. Chip-based analysis of exosomal mRNA mediating drug resistance in glioblastoma. Nat Commun, 6:6999, May 2015. [PubMed Central:\href https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430127PMC4430127] [DOI:\href https://dx.doi.org/10.1038/ncomms799910.1038/ncomms7999] [PubMed:\href https://www.ncbi.nlm.nih.gov/pubmed/2553693425536934].


Real-time monitoring of drug efficacy in glioblastoma multiforme (GBM) is a major clinical problem as serial re-biopsy of primary tumours is often not a clinical option. MGMT (O(6)-methylguanine DNA methyltransferase) and APNG (alkylpurine-DNA-N-glycosylase) are key enzymes capable of repairing temozolomide-induced DNA damages and their levels in tissue are inversely related to treatment efficacy. Yet, serial clinical analysis remains difficult, and, when done, primarily relies on promoter methylation studies of tumour biopsy material at the time of initial surgery. Here we present a microfluidic chip to analyse mRNA levels of MGMT and APNG in enriched tumour exosomes obtained from blood. We show that exosomal mRNA levels of these enzymes correlate well with levels found in parental cells and that levels change considerably during treatment of seven patients. We propose that if validated on a larger cohort of patients, the method may be used to predict drug response in GBM patients.